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Medicine Matters

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Medicine Matters Home Patient Care Epic Tip of the Week: April 30, 2021

Epic Tip of the Week: April 30, 2021

Ambulatory: Epic Efficiency Series

The Epic Sprint team is hosting the Epic Efficiency Webinar Series targeted to ambulatory providers. The webinars are held virtually via Zoom on the 2nd  Thursday and 4th Wednesday of the month.

To receive future webinar notifications about various Epic topics, subscribe by sending an email to sympa@lists.johnshopkins.edu. In the Subject line enter “subscribe epic-efficiency-series LastName, FirstName”

Mark your Calendars for the Next webinar: “In Basket - Results, Rx Refills, & Quick Actions”

Learning Objectives: Without leaving the In Basket, navigate components within the In Basket and complete In Basket tasks

  • When: Thursday, May 13, 2021 12:00 PM-1:00 PM
  • Where: Zoom => “Join with computer audio” using this link: https://jhjhm.zoom.us/j/4107356227
  • Qualifies for ONE AMA PRA Category 1 credit(s) TM
    Note: CME credit is available for live viewing only. Sessions will be recorded and posted on the Mastery Training tile of the Epic Training Portal.

Ambulatory: Telemedicine Hot Topics – States of Emergency Telehealth Services Expiring [Data as of 4/28/21, 1 p.m.]

  • Emergency orders/states of emergency are starting to expire in many states. This impacts provider’s ability to perform telemedicine visits for out-of-state patients.
    • Delaware: unless you are a mental health professional (psychologists, mental health counselors, chemical dependency professionals and social workers) or currently hold a professional license issued by the State of Delaware, per the Division of Professional Regulation, telehealth visits with patients located in Delaware are no longer permitted.
    • Washington, D.C.: telehealth practice with established patients has been extended and is set to expire on 5/15/21 [allows for 60 day grace period to wind down patient visits following waiver expiration date]
    • Pennsylvania: the licensure waiver for Pennsylvania telehealth practice is set to expire 5/20/21
    • Florida: extended through 6/27/21
      1. Providers are encouraged to obtain a Florida Telemedicine Registration to continue to see patients once the waiver expires. A tip sheet for this process can be found here.
      2. This license is no cost to you; however, some states may require a fee to send Florida proof of your existing licenses. The typical turnaround time is 1-2 business days.
    • New Jersey: expires 6/30/21
    • New York: expires 5/6/21
  • Refer to legal FAQs for information related to individual state waivers and licensing requirements
  • Direct general questions to JHM Telemedicine or legal-specific questions to Telemedicine Legal

Ambulatory: New Whole Health Assessment (WHA) Chief Complaint/Reason for Visit

  • The Medicare Advantage Whole Health Assessment (WHA) ensures annual management of chronic health conditions and preventative care. For differences between Annual Wellness Visits [AWV] vs WHA click here.
  • The Whole Health Assessment (WHA) Chief Complaint/Reason for Visit improves communication indicating that a WHA is due to be completed once/calendar year during any visit.
    • Select ‘Visit Info’ section in the Rooming Activity, enter WHA or Whole in the Chief Complaint field.
    • Create a button by clicking on the wrench

Inpatient & Ambulatory: Home Care Smart Set => Revised Oxygen Order

Two changes to the Oxygen for Home Use order

  • Liters Per Minute is required if a Device other than “Other” has been selected. If “Other “ device is selected, enter a free text description
  • The question “Order Portable Oxygen” was added, with a “Yes” response defaulted.

Inpatient: Heparin Infusion Management – JHH & JHBMC

  • Goals: to increase standardization and decrease medication errors. A brief recording is below:
  • Heparin infusions will be dosed units/kg/hr., in both the JHH-BMC Adult Prescriber Managed Heparin Infusion Focused Order Set and JHH-BMC Adult Nurse Managed Heparin Infusion Focused Order Set
    • A dosing weight is required. If weight was not documented before the Order Set is opened a warning will appear.
    • Click on the blue hyperlink to document a dosing weight; close and reopen the order set
  • In the JHH-BMC Adult Nurse Managed Heparin Infusion Focused Order Set a protocol or prescriber-specified order option are provided for Standard, ACS, and Low Goal Heparin.
    • Guidance for when to use a protocol vs. prescriber-specified option are displayed in the order.
    • ‘With’ or ‘without’ a bolus dose options are available.
  • In the JHH-BMC Adult Prescriber Managed Heparin Infusion Focused Order Set, for Therapeutic Heparin Infusions, note the following updates:
    • When initiating therapeutic heparin, both the infusion and a bolus will be ordered by default.
    • Depending on the patient’s weight, the standard bolus dose or initial infusion rate defaults in the orders for therapeutic heparin.
    • A Smartlist is used to select either an Anti-Xa UFH goal or aPTT goal.
    • Two different heparin RE-bolus orders are available:
      • 35 units/kg
      • 70 units/kg

Screenshots of the above can be found here.

COVID-19 Epic Training Portal link

Epic Training Portal link

For more Epic Tips of the Week, click here.

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Kelsey Bennett